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The limited number of 3D patient-based breast phantoms available could be augmented by synthetic breast phantoms in order to facilitate virtual clinical trials (VCTs) using model observers for breast imaging optimization and evaluation.These synthetic breast phantoms were developed using Principal Component Analysis (PCA) to reduce the number of dimensions needed to describe a training set of images. PCA decomposed a training set of M breast CT volumes (with millions of voxels each) into an M-1-dimensional space of eigenvectors, which we call eigenbreasts. Each of the training breast phantoms was compactly represented by the mean image plus a weighted sum of eigenbreasts. The distribution of weights observed from training was then sampled to create new synthesized breast phantoms.The resulting synthesized breast phantoms demonstrated a high degree of realism, as supported by an observer study. Two out of three experienced physicist observers were unable to distinguish between the synthesized breast phantoms and the patient-based phantoms. The fibroglandular density and noise power law exponent of the synthesized breast phantoms agreed well with the training data.Our method extends our series of digital breast phantoms based on breast CT data, providing the capability to generate new, statistically varying ensembles consisting of tens of thousands of virtual subjects. This work represents an important step toward conducting future virtual trials for task-based assessment of breast imaging, where it is vital to have a large ensemble of realistic phantoms for statistical power as well as clinical relevance.